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Licensing details for: 81865

Name: KYLE POULSEN, DDS

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

32897 WESTERN HILLS DRIVE, SUITE 102
WINCHESTER CA 92596
RIVERSIDE county
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Practice Location

32897 WESTERN HILLS DRIVE, SUITE 102
WINCHESTER CA 92596
RIVERSIDE county
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Issuance Date

August 2, 2024

Expiration Date

January 31, 2026

Current Date / Time

June 7, 2025
7:39:21 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: POULSEN, KYLE DOUGLASS

License/Registration Type: Dentist License

License Number: 64955 Primary Status: Current - Active

Address :
32891 Western Hills Dr
Ste 103
WINCHESTER CA 92596
RIVERSIDE COUNTY

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